Risk assessmentindependent cross-checkabstract only checked I-DRY-16 standard review

Mould toxin found in Middle-East milk, including Egypt

The prevalence of aflatoxin M1 in milk of Middle East region: A systematic review, meta-analysis and probabilistic health risk assessment.

Overview

Rahmani J et al.. Food Chem Toxicol 2018 · PMID 29902498 · DOI 10.1016/j.fct.2018.06.016

Egyptian raw milk: 38% of samples positive; estimated hazard index 0.84 for children.

Does the study support the specific claim? Partly · Methodological quality: moderate

Study explained simply

What did the researchers want to find out?: AFM1 in regional milk.
How was the study done?: Meta-analysis + risk model.
How many people, animals or samples were studied?: 49 studies.
What was actually found?: Contamination common; limits sometimes exceeded.
How large was the observed effect?: Egypt HI 0.18 adults / 0.84 children.
What do the results mean in everyday life?: Food control matters.
What are the study's limitations?: Model-based.
What does it say about Elawady's specific claim?: Partly supports residue concerns.
Do the results apply to Germany and Europe?: Low for EU.
What can explicitly not be concluded from this study?: That milk itself is harmful.

Prevalence/concentration of AFM1 in Middle-East cow milk and carcinogenic risk.

Study design: Risk assessment – Systematic review, meta-analysis and probabilistic risk assessment (Monte Carlo) of aflatoxin M1 in milk.
Population: Milk samples from Middle-East countries
Country: Middle East incl. Egypt
Period: 1995-Dec 2017
Sample size: 49 articles; 7,484 data
Inclusion and exclusion criteria: Studies on AFM1 in cow milk.

Results: Pooled AFM1: UHT 82.57 ng/kg > raw 60.37 > pasteurised 45.81; raw and UHT above EC limit. Raw milk prevalence: Egypt 38%. Hazard index raw milk adults: Egypt 0.18; children: Egypt 0.84; children in several countries HI >1.
Absolute risks: not reported (hazard index)
Authors' conclusion: Unlike adults, children in several Middle-East countries are at considerable cancer risk from AFM1 in milk.

Estimates are exposure-model outputs, not observed disease.

Mixed for C-DRY-01: contamination is real but concerns feed control, not 'milk = blood'.

n/a

Low (EU limits enforced).

Real regional contamination issue.

Multidimensional assessment
Multidimensional assessment
Authenticity of the source	verified
Methodological quality	moderate
Risk of bias	some concerns
Precision of results	low
Directness	indirect
Reproducibility	partly replicated
Consistency with the overall evidence	mixed
Regional transferability	high
Adequacy of the interpretation (by the archive)	not applicable

Current Egyptian data; cheese and butter levels.